Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW
Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW.
Med J Aust. 2018 Jun 2;209(1):19-23. doi: 10.5694/mja17.00878.
To compare the prevalence of multimorbidity and its impact on mortality among Aboriginal and non-Aboriginal Australians who had been hospitalised in New South Wales in the previous 10 years.
DESIGN, SETTING AND PARTICIPANTS: Cohort study analysis of linked NSW hospital (Admitted Patient Data Collection) and mortality data for 5 437 018 New South Wales residents with an admission to a NSW hospital between 1 March 2003 and 1 March 2013, and alive at 1 March 2013.
Admissions for 30 morbidities during the 10-year study period were identified. The primary outcome was the presence or absence of multimorbidity during the 10-year lookback period; the secondary outcome was mortality in the 12 months from 1 March 2013 to 1 March 2014.
31.5% of Aboriginal patients had at least one morbidity and 16.1% had two or more, compared with 25.0% and 12.1% of non-Aboriginal patients. After adjusting for age, sex, and socio-economic status, the prevalence of multimorbidity among Aboriginal people was 2.59 times that for non-Aboriginal people (95% CI, 2.55-2.62). The prevalence of multimorbidity was higher among Aboriginal people in all age groups, in younger age groups because of the higher prevalence of mental morbidities, and from age 60 because of physical morbidities. The age-, sex- and socio-economic status-adjusted hazard of one-year mortality (Aboriginal v non-Aboriginal Australians) was 2.43 (95% CI, 2.24-2.62), and 1.51 (95% CI, 1.39-1.63) after also adjusting for morbidity count.
The prevalence of multimorbidity was higher among Aboriginal than non-Aboriginal patients, and this difference accounted for much of the difference in mortality between the two groups. Evidence-based interventions for reducing multimorbidity among Aboriginal and Torres Strait Islander Australians must be a priority.
比较过去 10 年在新南威尔士州住院的原住民和非原住民澳大利亚人多发性疾病的患病率及其对死亡率的影响。
设计、地点和参与者：对新南威尔士州医院（入院患者数据采集）和死亡率数据进行的队列研究分析，共纳入了 5437018 名新南威尔士州居民，他们在 2003 年 3 月 1 日至 2013 年 3 月 1 日期间在新南威尔士州的一家医院住院，并且在 2013 年 3 月 1 日仍存活。
在 10 年的研究期间确定了 30 种疾病的入院情况。主要结局是在 10 年回顾期间是否存在多发性疾病；次要结局是 2013 年 3 月 1 日至 2014 年 3 月 1 日期间的 12 个月内的死亡率。
31.5%的原住民患者至少有一种疾病，16.1%有两种或更多种疾病，而非原住民患者的比例分别为 25.0%和 12.1%。在调整年龄、性别和社会经济地位后，原住民人群多发性疾病的患病率是非原住民人群的 2.59 倍（95%CI，2.55-2.62）。在所有年龄组中，原住民人群的多发性疾病患病率都更高，在年轻人群中，由于精神疾病的患病率更高，而在 60 岁以上人群中，则由于身体疾病的患病率更高。调整年龄、性别和社会经济地位后，一年死亡率（原住民与非原住民澳大利亚人）的调整危险比为 2.43（95%CI，2.24-2.62），在还调整疾病数量后，这一比值为 1.51（95%CI，1.39-1.63）。
原住民患者多发性疾病的患病率高于非原住民患者，这种差异在两组人群的死亡率差异中占很大比例。针对减少澳大利亚原住民和托雷斯海峡岛民多发性疾病的循证干预措施必须成为当务之急。
